ENDO

A nurse is providing postoperative care for a client one hour after an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse should monitor the client for which complication?

Hypotension

Which statement does the nurse know is true regarding a grade 2 goiter?

A goiter is usually asymmetrical.

Which gland secretes melatonin?

Pineal gland

Which hormone overproduction is associated with carpel tunnel syndrome in clients?

Growth hormone

A client suspected to have hyperpituitarism is sent by the primary healthcare provider to undergo a suppression test. Which laboratory value would indicate a positive result

6 ng/mL

A client has a tentative diagnosis of Cushing syndrome. What physical symptoms will the client exhibit?

Hypertension and moon face

A client with hyperthyroidism asks the nurse about the tests that will be prescribed. Which diagnostic tests should the nurse include in a discussion with this client?

Thyroid-stimulating hormone (TSH) assay and triiodothyronine (T3)

Which neurologic manifestation in a client is associated with hyperthyroidism?

Exophthalmos

A client with type 1 diabetes is transported via ambulance to the emergency department of the hospital. The client has dry, hot, flushed skin and a fruity odor to the breath and is having Kussmaul respirations. Which complication does the nurse suspect that the client is experiencing?

Ketoacidosis

Which catecholamine receptor is responsible for increased heart rate?

Beta1 receptor

The clinical findings of a client with diabetes mellitus show decreased glucose tolerance. Which complication is anticipated in the client?

Frequent yeast infection

While obtaining the client's health history, which factor does the nurse identify that predisposes the client to type 2 diabetes?

Being 20 pounds (9 kilograms) overweight

A client presents with chief complaints of unexplained weight gain and back pain from a compression fracture of the vertebrae. On assessment, there is truncal obesity with excessively thin extremities, a moon-shaped face, a buffalo hump, thin hair, and adult acne. The symptoms described are suggestive of what disease?

Cushing disease

Which is the target tissue for the parathyroid gland?

Intestines

A client is diagnosed with hyperthyroidism, and surgery is scheduled because the client refuses ablation therapy. While awaiting the surgical date, what instruction should the nurse teach the client?

Eliminate coffee, tea, and cola from the diet.

Which statement is true regarding cortisol?

Cortisol stimulates gluconeogenesis.

In order to ensure a quality specimen and an accurate test result, which instruction should the nurse give a client who is scheduled to undergo urine endocrine testing?

"Store the urine specimen in a cooler with ice."

After surgical clipping of a ruptured cerebral aneurysm, a client develops the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). What manifestations are exhibited with excessive levels of antidiuretic hormone?

Hyponatremia and decreased urine output

A nurse is caring for a client with Addison disease. Which information should the nurse include in a teaching plan to encourage this client to modify dietary intake?

Extra salt is needed to replace the amount being lost caused by lack of sufficient aldosterone to conserve sodium.

What does the nurse state as the etiological factor of nephrogenic diabetes insipidus (DI)?

Lithium therapy

A nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective?

"I should control my blood glucose with diet, exercise, and medication."

A nurse is monitoring a client's laboratory results for a fasting plasma glucose level. Within which range of a fasting plasma glucose level does the nurse conclude that a client is considered to be diabetic?

126

A nurse is caring for a client with a diagnosis of type 1 diabetes who has developed diabetic coma. Which element excessively accumulates in the blood to precipitate the signs and symptoms associated with this condition?

Ketones as a result of rapid fat breakdown, causing acidosis

Which statement regarding calcitonin is correct?

Its actions are opposite to that of parathyroid hormone.

A nurse working in the diabetes clinic is evaluating a client's success with managing the medical regimen. What is the best indication that a client with type 1 diabetes is successfully managing the disease?

Stabilization of the serum glucose

A primary healthcare provider prescribes a low-sodium, high-potassium diet for a client with Cushing syndrome. Which explanation should the nurse provide to the client about the need to follow this diet?

"Excessive aldosterone and cortisone cause retention of sodium and loss of potassium."

Which hormonal deficiency reduces the growth of axillae and pubic hair in female clients?

Adrenocorticotropic hormone

Which hormone does the nurse state binds to the receptor site on the surface of a target cell?

Adrenaline

A client with malignant hot nodules of the thyroid gland has a thyroidectomy. What is the nurse's priority action immediately postoperative?

Place in low-Fowler position to limit edema of the neck

Which hormone is released from the pancreas?

Somatostatin

A nurse observes that a client's urine has a sweet fruity odor. Which information is most important to evaluate when performing a further client assessment?

Serum glucose level

A nurse explains to a client with diabetes that self-monitoring of blood glucose is preferred to urine glucose testing. Why is blood glucose monitoring preferred?

Blood glucose monitoring is more accurate.

Which hormonal deficiency causes diabetes insipidus in a client?

Antidiuretic hormone (ADH)

A client reports their lips feel thicker, as well as joint pain and coarse facial features. What should the nurse suspect as the cause of the anterior

Excessive secretion of growth hormone

What are the most common hormones produced in excess with hyperpituitarism? Select all that apply.

Prolactin, Growth Hormone

What will the nurse expect diagnostic studies of a client with Cushing syndrome to indicate?

High levels of 17-ketosteroids in a 24-hour urine test

What other name can the nurse use for vasopressin?

Antidiuretic hormone

What are the neurologic manifestations of hyperthyroidism?

Blurred vision Exophthalmos

A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include to decrease the risk of complications?

Examine the feet daily Wear well-fitting shoes Perform regular exercise

A nurse is caring for a client who has just returned from the postanesthesia care unit after having a thyroidectomy. Which action has priority during the first 24 hours after surgery when the nurse is concerned about thyroid storm?

Checking vital signs every two hours after they stabilize

The serum potassium level of a client who has diabetic ketoacidosis is 5.4 mEq/L (5.4 mmol/L). What would the nurse expect to see on the ECG tracing monitor?

Peaked T waves and widened QRS complexes

Which hormone does the nurse state has both inhibiting and releasing action?

Prolactin

Which medical condition could most probably result in clients developing primary diabetes insipidus (DI)?

Defect in hypothalamus

Which adverse effect can be seen in a female client with gonadotropin deficiency and undergoing hormone replacement therapy?

Thrombosis

A client who has had a subtotal thyroidectomy does not understand how hypothyroidism can develop when the problem was initially hyperthyroidism. On what fact should the nurse base her response?

There may not be enough thyroid tissue to supply adequate thyroid hormone.

A nurse is teaching a client with type 1 diabetes about assessing for signs and symptoms of hypoglycemia as a result of excessive insulin. What response should the nurse instruct the client to monitor in addition to nervousness and hunger?

Sweating

The nurse is caring for the client posttranssphenoidal hypophysectomy. When assessing the client, the nurse observes clear drainage from the nares. What could be the cause of this drainage?

A cerebral spinal fluid leak from an opening to the brain.

Which drug can cause diabetes insipidus?

Demeclocycline

A nurse is caring for a client newly diagnosed with type 1 diabetes. When the primary healthcare provider tries to regulate this client's insulin regimen, the client experiences episodes of hypoglycemia and hyperglycemia, and 15 g of a simple sugar is prescribed. What is the reason this is administered when a client experiences hypoglycemia?

Increases blood glucose levels

A client is admitted for hypertension, and serum electrolyte studies have yielded abnormal results. The scheduled workup includes a scan for an aldosteronoma. What disease will this scan rule out?

Adrenal cortex

A client with type 2 diabetes, who is taking an oral hypoglycemic agent, is to have a serum glucose test early in the morning. The client asks the nurse, "What do I have to do to prepare for this test?" Which statement by the nurse reflects accurate information?

"Do not ingest anything before the test."

Which clinical manifestation occurs in a client with vasopressin deficiency?

Hypotension

A client who had a subtotal thyroidectomy asks how hypothyroidism may develop when the problem was hyperthyroidism. What should the nurse consider when formulating a response?

Less thyroid tissue is available to supply thyroid hormone after surgery.

Which hormonal deficiency causes breast atrophy in female clients?

Luteinizing hormone

Which condition is characterized by hemorrhage after a pregnant female delivers?

Sheehan's syndrome

A client, visiting the health center, reports feeling nervous, irritable, and extremely tired. The client says to the nurse, "Although I eat a lot of food, I have frequent bouts of diarrhea and am losing weight." The nurse observes a fine hand tremor, an exaggerated reaction to external stimuli, and a wide-eyed expression. What laboratory tests may be prescribed to determine the cause of these signs and symptoms?

T3, T4, and thyroid-stimulating hormone (TSH)

Which hormone does the nurse state is formed from cholesterol?

Cortisol

The laboratory report of a client reveals increased serum cholesterol levels. Which other finding indicates growth hormone deficiency in the client?

Pathological fractures

The client's pituitary gland must be removed. Which surgery will the client undergo?

Hypophysectomy

A nurse is reviewing several charts. Which condition is an autoimmune disorder?

Hashimoto's disease

Four hours after surgery, the blood glucose level of a client who has type 1 diabetes is elevated. What intervention should the nurse implement?

Give supplemental doses of regular insulin

Which assessment finding in a client signifies a mild form of hypocalcemia?

Numbness around the mouth

Which hormone secretion does the nurse state is an example of a positive feedback mechanism?

Estradiol

Which hormonal deficiency would increase the client's risk for fractures?

Growth Hormone

The registered nurse instructs the new nurse in orientation regarding the physiologic processes of the endocrine system prior to client assessment. Which statement made by the new nurse indicates effective learning?

"The hormones of the endocrine system exert their action by 'lock and key' mechanism."

A nurse teaches a client who has had a thyroidectomy for thyroid cancer to observe for signs of surgically induced hypothyroidism. What should be included in the teaching plan? Select all that apply.

Dry skin Lethargy Sensitivity to cold

A nurse is assessing a client with Cushing syndrome. Which signs should the nurse expect the client to exhibit? Select all that apply.

Hirsutism Round face Buffalo hump

What are the cardiovascular manifestations observed in a client with adrenal insufficiency?

Hyponatremia

What are the most common hormones produced in excess with hyperpituitarism? Select all that apply.

Prolactin Growth hormone

Which feature in the client indicates hypersecretion of adrenocorticotrophic hormone?

Moon Face

Which hormones does the nurse state are released by the hypothalamus? Select all that apply.

Melanocyte-inhibiting hormone (MIH) Corticotropin-releasing hormone (CRH) Growth hormone-releasing hormone (GHRH)

What assessment is the nurse's main priority during the early postoperative period after a subtotal thyroidectomy?

Airway obstruction

Which procedure is preferred to find out the composition of a thyroid nodule and ascertain the need for further surgical intervention in a client?

Needle Biopsy

When obtaining a health history from a client recently diagnosed with type 1 diabetes, the nurse expects the client to report what clinical manifestations?

Polyuria, polydipsia, and polyphagia

How does the nurse arrange the events that take place during the promotion of glucose transportation into the cells through cell membranes?

Secretion of proinsulin by beta cells Storage of proinsulin in the pancreas Transformation of proinsulin into active insulin Attachment of insulin to receptors

A client has a history of hypothyroidism. Which skin condition should the nurse expect when performing a physical assessment?

Dry

What are the primary causes of adrenal insufficiency? Select all that apply.

Hemorrhage Tuberculosis Acquired immune deficiency syndrome

A client complains of fatigue, hair loss, and weight gain. On assessment, the client is found to have anemia. Which therapy does the nurse anticipate in the client's prescription?

Levothyroxine

Which statement made by a diabetic client shows that dietary teaching by the nurse was effective?

"My diet can be planned around a wide variety of commonly used foods."

While assessing the health of a female client, the nurse suspects endocrine dysfunction. Which findings support the nurse's suspicion? Select all that apply.

Diminished pubic hair Protrusion of eyeballs Blood pressure of 172/80 mm Hg

A client with Cushing syndrome asks why a low-sodium, high-potassium diet has been prescribed. What is the best response by the nurse?

"Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium."

The nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which finding in the client is consistent with the diagnosis?

retention of water

A client reports backache and abnormal increase in shoe size. The primary healthcare provider prescribes 100 g of oral glucose and blood and urine samples are collected for testing. Which finding in the client indicates an abnormality?

Growth hormone level is 7 ng/mL

A client with a family history of goiter is experiencing changes in voice and breathing. Which diagnostic study does the nurse consider to be beneficial in confirming a diagnosis?

Thyroid antibodies

While reviewing the laboratory reports of a client, the nurse finds that the client has low sodium levels. Which hormonal imbalance should the nurse suspect in the client?

Cortisol

A client is admitted to the hospital for a thyroidectomy. In which position should the nurse maintain the client after surgery?

Semi fowler

During the progressive stage of shock, anaerobic metabolism occurs. Which complication should the nurse anticipate in this client?

Metabolic acidosis

A primary healthcare provider prescribes propylthiouracil (PTU) for a client with hyperthyroidism. Two months after being started on the antithyroid medication, the client calls the nurse and complains of feeling tired and looking pale. What should the nurse do?

Schedule the client for an appointment.

A client's parathyroid glands are removed. What clinical manifestation is indicative of the fluid and electrolyte imbalance associated with this surgery?

Muscle spasms

The nurse is caring for a client newly diagnosed with diabetes. What symptom of hypoglycemia is most common and should be taught to the client?

Confusion

A client is scheduled to have a thyroidectomy for thyroid cancer. What specific instruction about postoperative care should the nurse provide the client during preoperative teaching?

Support the head with the hands when changing position.

When obtaining the history of a client recently diagnosed with type 1 diabetes, what will the nurse expect to discover?

Weight loss

After assessing a client, the nurse anticipates that the client has hyperpituitarism. Which questions asked by the nurse helps confirm the diagnosis? Select all that apply.

"Is there any change in your vision?" "Do you experience severe headaches?" "Is there any change in your menstrual cycle?"

On reviewing the data of a client with thyroid disorder, the primary healthcare provider prescribed atenolol. Which assessment findings would indicate the need for atenolol therapy? Select all that apply.

Tachycardia Atrial fibrillation Systolic hypertension

The nurse is caring for a client with nephrogenic diabetes insipidus who is prescribed a low-sodium diet and chlorothiazide therapy. The client fails to respond to the therapy. Which alternative treatment should the nurse be prepared to administer?

Indomethacin

A nurse is assessing a client admitted to the hospital with a tentative diagnosis of a pituitary tumor. What signs of Cushing syndrome does the nurse identify?

Retention of sodium and water q

A female client is undergoing treatment for infertility. After therapy with clomiphene the client comes for follow-up visits and no results are seen. What further treatment does the nurse anticipate administering?

Human chorionic gonadotropin

The primary healthcare provider instructs the client to increase their intake of seafood and protein in the diet. What could be the reason for this instruction?

The client has hypothyroidism.

A client has a glycosylated hemoglobin measurement of 6%. What should the nurse conclude about this client when planning teaching strategies based on the results of this laboratory test?

The client has followed the treatment plan as prescribed.

The laboratory reports of a client who underwent a hypophysectomy show an intracranial pressure (ICP) of 20 mmHg. Which action made by the client is responsible for this condition?

Bending over at the waist

A female client who is scheduled for a thyroidectomy is concerned that the surgery will interfere with her ability to become pregnant. What is the nurse's best response?

"As long as medication is continued, ovulation will occur."

The primary healthcare provider prescribes daily fasting blood glucose levels for a client with diabetes mellitus. What is the goal of treatment with glucose levels for this client?

70 to 105 mg/dL (3.9 to 5.8 mmol/L) of blood

The nurse is assisting the primary healthcare provider, who is examining the client's skull radiograph. An abnormality in the endocrine gland situated in a depression of the sphenoid bone is suspected. Which hormone release is most probably affected?

Corticotropin

A nurse is caring for a client who is experiencing an underproduction of thyroxine (T4). Which client response is associated with an underproduction of thyroxine?

Myxedema

While assessing a postpartum client who is suspected of having a thyroid disorder, the nurse suspects that the client has autoimmune thyroiditis. Which diagnostic studies are most suitable for confirming the diagnosis?

Radioactive iodine uptake

What is the effect of parathyroid hormone on bones? Select all that apply.

Increased bone breakdown Increased serum calcium levels Increased net release of calcium and phosphorus

While caring for a client receiving hydrocortisone therapy, the nurse anticipates a dose adjustment in the client's prescription. Which observation in the client supports this anticipation?

Sudden weight gain of 8 kg

A client with type 1 diabetes has an above-the-knee amputation because of severe lower extremity arterial disease. What is the nurse's primary responsibility two days after surgery when preparing the client to eat dinner?

Checking the client's serum glucose level

A nurse is caring for a client with Cushing syndrome. Which cardiovascular complication should the nurse assess for in this client?

Hyptension

A nurse is caring for a newly admitted client with a diagnosis of Graves disease. In preparing a teaching plan, the nurse anticipates which diet will be prescribed for this client?

High-calorie diet

A nurse provides post-operative care to a client who has undergone a hypophysectomy. Which action should the nurse take if there is a yellowish discharge at the dressing site?

Inform the primary healthcare provider

Postoperatively, a client who had a thyroidectomy complains of tingling and numbness of the fingers and toes, and the nurse observes muscle twitching. Which complication does the nurse suspect the client is experiencing?

Hypocalcemia

Upon assessing a female client, the nurse discovers an abnormal endocrine finding. Which finding in the client supports the nurse's conclusion?

Protruding eyes

The primary healthcare provider prescribed carbamazepine to a client with central diabetes insipidus. The serum osmolarity is 600 mOsm (mmol)/kg. Which will be an effective outcome of the drug?

Decreased thirst

The primary health care provider prescribes fludrocortisone to a client with adrenal gland hypofunction. What does the nurse instruct the client about this medication?

"Regularly monitor blood pressure."

On the first postoperative day following a thyroidectomy, a client tolerates a full-fluid diet. This is changed to a soft diet on the second postoperative day. The client reports a sore throat when swallowing. What should the nurse do first?

Administer analgesics as prescribed before meals.

During thyroid surgery, a client's parathyroid glands have become damaged. Which condition does the nurse expect the client to develop?

Tetany

A client with a parathyroid disorder reports nausea, vomiting, weight loss, and epigastric pain. Which electrolyte disturbance would be responsible for the client's clinical manifestations?

Hypercalcemia

During a follow-up visit, the nurse finds increased intracranial pressure in a client who has undergone nasal hypophysectomy for hyperpituitarism. Which action taken by the client is responsible for this condition?

Blowing the nose and sneezing

A client feeling increasingly tired seeks medical care. Type 1 diabetes is diagnosed. What causes increased fatigue with type 1 diabetes?

Decreased production of insulin by the pancreas

Which drug acts as an abortifacient in female clients?

Mifepristone

Which electrolyte concentration has the potential to precipitate dysrhythmias and cardiac arrest in a client?

Serum potassium of 7.2 mEq/L (7.2 mmol/L)

A client complains of weight gain and purplish-blue striae on the abdomen. Which condition does the nurse anticipate in the client?

Cushing

The nurse is caring for a client immediately after a subtotal thyroidectomy. How will the nurse assess for unilateral injury of the laryngeal nerve?

Asking the client to say what the current time is

When assessing a client with Graves disease (hyperthyroidism), what would the nurse expect to find in the client's history?

Diaphoresis

Which clinical manifestations in a client indicate hyperfunctional thyroid gland? Select all that apply.

Diarrhea weight loss

Which nursing intervention is the priority when a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?

Administering fluid replacement

Which clinical feature is indicative when a client has hypercortisolism?

Increased pigmentation

A client reports enlargement of the hands and feet, thickened lips, and joint pains. The client's blood glucose is 250 mg/dL (13.89 mmol/L) and x-ray reports reveal increased size of the lungs. Which hormonal change does the nurse suspect in the client?

Growth hormone

The nurse is assessing the client admitted with diabetic ketoacidosis. Which statement made by the client indicates a need for further education on sick day management?

"I need to stop taking my insulin when I am ill because I am not eating."

A client is admitted to the hospital with a possible diagnosis of Addison disease. What is an important nursing responsibility during a 24-hour urine collection for this client?

Keeping the client quiet and reducing stress

A nurse is caring for a client with a history of hyperthyroidism who is now experiencing thyroid crisis (thyroid storm). What does the nurse consider to be the most likely precipitating factor in the client's current health problem?

High levels of the hormone triiodothyronine

The nurse is assessing a client suspected of having hypersecretion of growth hormone. Which question should the nurse ask the client?

"Have you noticed thickening of your lips?"

A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiologic changes associated with a long history of diabetes?

Blurry, spotty, or hazy vision

A client who is scheduled to have surgery to remove an aldosterone-secreting adenoma asks the nurse what will happen if surgery is not performed. On what information should the nurse base a response?

The tumor must be removed to prevent heart and kidney damage.

A nurse is caring for a client with type 1 diabetes who developed ketoacidosis. Which laboratory value supports the presence of diabetic ketoacidosis?

Increased blood urea nitrogen levels OR Increased serum lipids

A client with severe diabetes insipidus is receiving desmopressin acetate, which is administered intranasally in a metered spray. During the follow-up visits, the client reports chest tightness to the primary healthcare provider. Which intervention would effectively reduce complications in the client? Select all that apply.

Administration of desmopressin acetate orally Administration of desmopressin acetate subcutaneously

A nurse is caring for a client who had an adrenalectomy. What clinical response should the nurse monitor while steroid therapy is being regulated?

Hypotension

A nurse is developing a discharge plan for a client hospitalized with severe cirrhosis of the liver. What should be included in this plan?

The importance of reporting personality changes to the primary healthcare provider

A registered nurse is teaching the student nurse the precautions to follow when blood samples are collected. Which statement made by the student nurse indicates effective learning?

"I can use a single-lumen line to obtain samples."

A nurse teaches a client with type 1 diabetes about the treatment of hypoglycemia. If the teaching is effective, which foods does the client identify to manage hypoglycemia?

Cheese sandwich and sugar

The nurse is caring for a client diagnosed with Cushing syndrome. What symptoms does the nurse expect the client to exhibit?

Lability of mood

A client is learning alternate site testing (AST) for glucose monitoring. Which client statement indicates to the nurse that additional teaching is necessary?

"The fingertip is preferred for glucose monitoring if hyperglycemia is suspected."

The nurse is teaching a diabetic client about the advantages of using an insulin pump. What information should the nurse include?

It can improve A1C levels. Clients can exercise without eating more carbohydrates.

The nurse is caring for a client in labor whose medical report states posterior pituitary hormone deficiency. Which medication administration is required for the client considering the medical condition?

Oxytocin to promote uterine contractions

A client with a small nodule of the thyroid gland is to have a subtotal thyroidectomy. The client asks the nurse for clarification about what this surgery involves. What information should the nurse include in a response to the question?

A small part of the gland is left intact.

A client with acromegaly and insulin-dependent diabetes undergoes a hypophysectomy. Which statement made by the client indicates a need for further teaching?

"I will require larger doses of insulin than I did preoperatively."

A nurse is caring for a client admitted to the hospital with primary hyperparathyroidism. Which action should be included in this client's plan of care?

Ensuring a large fluid intake

The nurse concludes that a client with type 1 diabetes is experiencing hypoglycemia. Which responses support this conclusion? Select all that apply.

Headache Tachycardia Cool, Clammy skin

The nurse is teaching a client who underwent bilateral adrenalectomy about self-management after discharge. Which statements given by the client indicate effective learning? Select all that apply.

"I will procure an influenza vaccination yearly." "I will visit the hospital frequently for my lifelong hormonal therapy." "I will immediately notify my primary health care provider if I have fever."

A nurse is caring for a client admitted to the hospital with a diagnosis of Addison disease. The nurse should assess the client for what signs related to this disorder?

Hypoglycemia and hypotension

Which assessment finding is characteristic of a client with hypoparathyroidism?

Serum phosphorus of 5 mg/dL (1.61 mmol/L); serum magnesium of 0.9 mEq/L (0.9 mmol/L)

The nurse provides education related to manifestations of hyperglycemia to a client with type 1 diabetes. Which signs and symptoms identified by the client indicate that the teaching was effective? Select all that apply.

Thirst Fruity breath odor Excessive urination

A nurse is caring for a client with the clinical manifestation of hypotension associated with a diagnosis of Addison disease. Which hormone is impaired in its production as a result of this disease?

Mineralocorticoids

A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings related to this event should the nurse document in the client's clinical record?

Acetone breath Decreased arterial carbon dioxide level

Which important intervention should the nurse include in the plan of care for a client with Addison disease?

Protecting the client from exertion

A client suspected of having a hyperactive thyroid is scheduled for protein-bound iodine, T3, and T4 laboratory tests. What should the nurse ask the client to ensure accuracy of the test?

Had recent x-rays using radiopaque dye

A client with addisonian crisis exhibits severe manifestations of glucocorticoid and mineralocorticoid deficiencies. Which responses should the nurse expect the client to exhibit?

Hyperkalemia Hyponatremia Postural hypotension

A client who has hypofunction of the adrenal gland is prescribed oral hydrocortisone. Which clinical finding indicates the need for dosage adjustment in the client? Select all that apply.

Fluid retention Rapid weight gain

A client with hyperthyroidism refuses radioactive iodine therapy, and a subtotal thyroidectomy is scheduled. The nurse reviews the preoperative plan of care and questions which prescription?

Drugs to increase the blood pressure

A nurse is caring for an older client who had non-insulin dependent diabetes for 15 years that progressed to insulin-dependent diabetes 2 years ago. What common complications of diabetes should the nurse assess for when examining this client? Select all that apply.

Leg ulcers Loss of visual acuity Prolonged capillary refill in the toes Decreased sensation in the lower extremities

A nurse is teaching a client with diabetes about the treatment of hypoglycemia. The nurse knows that teaching was effective if the client picks which foods to treat a hypoglycemic attack?

Sugar and a slice of bread.

A nurse is assessing a malnourished client with a history of cirrhosis. The client is experiencing nausea, ascites, and gastrointestinal bleeding. What is the primary cause of the client's ascites?

A decrease in plasma protein to maintain adequate capillary-tissue circulation `

The laboratory reports of a client reveal selective hypopituitarism related to growth hormone (GH). What other findings does the nurse anticipate in the client? Select all that apply.

Decreased muscle strength Increased serum cholesterol

A client is diagnosed as having type 2 diabetes. What is a priority teaching goal for the client?

To identify pending hypoglycemia or hyperglycemia

A nurse is caring for an adult client with acromegaly. What clinical manifestation does the nurse expect the client to exhibit?

Prominent jaw

A female client has decreased bone density, dry skin, and dry perineal tissues, and the primary healthcare provider has identified a risk of cystitis. Which teaching should the nurse provide to the client? Select all that apply.

"Perform weight-bearing activity." "Drink at least 2 liters of fluids daily." "Use vaginal lubricants during sexual activity."

A nurse is caring for a client after a thyroidectomy. With concerns of nerve injury, what functional ability should the client be assessed for?

Speaking

A client has an abdominal perineal resection with the formation of a colostomy for cancer of the rectum. The nurse evaluates that teaching about colostomy care is understood when the client makes what statement?

"I will call the clinic and report if I have difficulty inserting the irrigating tube into the stoma."

The nurse is teaching a student nurse about caring for a client with decreased bone density. Which statements made by the student nurse indicates effective learning? Select all that apply.

"I will instruct the client to be very careful to prevent injuries." "I will instruct the client to perform weight-bearing activities."

What is a major nursing concern when caring for a client diagnosed with hyperthyroidism?

Arranging for sufficient rest periods

A client's laboratory report reveals decreased serum and salivary cortisol levels and increased serum potassium level from hypofunctioning of the adrenal gland. The client is prescribed fludrocortisone. Which nursing action in the follow-up visit minimizes risk of a potential side effect of medication?

Monitoring the client's blood pressure

The registered nurse is teaching the student nurse how to care for a client with hyperpituitarism who is being treated with bromocriptine mesylate. Which statement made by the student nurse indicates effective learning?

Low dose of the drug should be given while initiating therapy.

A nurse is reviewing a client's history and finds images showing progressive development of facial changes due to acromegaly. Which diagnostic study would have confirmed this diagnosis?

Insulin-like growth factor 1 (IGF-1)

A client is scheduled for a computed tomography (CT) of the brain with contrast. When reviewing the client's medical record, what significant finding should the nurse report to the primary healthcare provider before the diagnostic procedure?

The client takes metformin daily.

A nurse is caring for a client with a tentative diagnosis of pheochromocytoma who is receiving chlorpromazine. A 24-hour urine specimen to assess the presence of vanillylmandelic acid (VMA) is prescribed to assist in confirmation of the diagnosis. What information should the nurse include in the client teaching regarding this test? Select all that apply.

All urine excreted over the 24-hour period must be saved and refrigerated. Avoid coffee, chocolate, and citrus fruit for three days before and during the test.

A client is worried about what to expect after having a pancreatoduodenectomy (Whipple procedure) for cancer of the pancreas. What is most important for the nurse to know when helping this client plan for the future?

The stage and grade of the client's cancer

A client who had a subtotal thyroidectomy returns to the unit from the postanesthesia care unit. What is the priority nursing action at this time?

Observe for signs of tetany.

What change in blood pressure (BP) should the nurse anticipate after a client has an aldosteronoma surgically removed?

Gradually return to expected levels for an adult

A client has undergone hypophysectomy. Which action would the nurse consider to be most appropriate during postoperative care to prevent a cerebrospinal fluid (CSF) leak?

Prohibiting coughing or sneezing

A client has a thyroidectomy for cancer of the thyroid. When evaluating for nerve injury, what should the client be asked to do?

Speak

A nurse is caring for a client with myxedema who has undergone abdominal surgery. What should the nurse consider when administering opioids to this client?

One-third to one-half the usual dose should be prescribed.

A client who is to begin continuous ambulatory peritoneal dialysis asks the nurse what this entails. What information should the nurse include when answering the client's question?

Constant contact is maintained between the dialysate and the peritoneal membrane.

The nurse is teaching a client who underwent a hypophysectomy for hyperpituitarism about self-management. Which actions performed by the client could cause complications on the second post-operative day? Select all that apply.

Nose blowing Teeth brushing Bending forward

What interventions should the nurse implement in caring for a client with diabetes insipidus (DI) following a head injury?

Providing adequate fluids within easy reach Assessing for and reporting changes in neurological status Monitoring for constipation, weight loss, hypotension, and tachycardia

A nurse is assessing a client with diabetes insipidus. Which signs indicative of diabetes insipidus should the nurse identify when assessing the client?

Excessive thirst Dry mucous membranes Decreased urine specific gravity

A client's laboratory values demonstrate an increased serum calcium level, and further diagnostic tests reveal hyperparathyroidism. What clinical manifestations might the nurse identify when assessing this client?

Cardiac dysrhythmias Hypoactive bowel sounds

A client is admitted with a diagnosis of Cushing syndrome. Which clinical manifestations should the nurse expect the client to exhibit?

Weakness Hypertension Truncal obesity

A nurse is assessing a client with a diagnosis of hypoglycemia. What clinical manifestations support this diagnosis?

Palpitations Diaphoresis Slurred speech

The client is admitted to the hospital with a large goiter, and a thyroidectomy is performed. What should the nurse do during the first four hours after the surgery?

Monitor for stridor or dyspnea Assess the sides and back of the client's neck for evidence of bleeding

Two clients with polydipsia and polyuria arrived at the hospital. Both were having similar symptoms but were diagnosed with different types of diabetes insipidus. Which assessment finding helped to differentiate the diagnosis?

Urine osmolarity

A nurse is monitoring for clinical manifestations of infection in a client with a diagnosis of Addison disease. Which body mechanism related to infectious processes does the nurse conclude is impaired as a result of this disease?

Stress response

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A nurse is providing postoperative care for a client one hour after an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse should monitor the client for which complication?

Hypotension

Which statement does the nurse know is true regarding a grade 2 goiter?

A goiter is usually asymmetrical.

Which gland secretes melatonin?

Pineal gland

Which hormone overproduction is associated with carpel tunnel syndrome in clients?

Growth hormone

A client suspected to have hyperpituitarism is sent by the primary healthcare provider to undergo a suppression test. Which laboratory value would indicate a positive result

6 ng/mL

A client has a tentative diagnosis of Cushing syndrome. What physical symptoms will the client exhibit?

Hypertension and moon face

A client with hyperthyroidism asks the nurse about the tests that will be prescribed. Which diagnostic tests should the nurse include in a discussion with this client?

Thyroid-stimulating hormone (TSH) assay and triiodothyronine (T3)

Which neurologic manifestation in a client is associated with hyperthyroidism?

Exophthalmos

A client with type 1 diabetes is transported via ambulance to the emergency department of the hospital. The client has dry, hot, flushed skin and a fruity odor to the breath and is having Kussmaul respirations. Which complication does the nurse suspect that the client is experiencing?

Ketoacidosis

Which catecholamine receptor is responsible for increased heart rate?

Beta1 receptor

The clinical findings of a client with diabetes mellitus show decreased glucose tolerance. Which complication is anticipated in the client?

Frequent yeast infection

While obtaining the client’s health history, which factor does the nurse identify that predisposes the client to type 2 diabetes?

Being 20 pounds (9 kilograms) overweight

A client presents with chief complaints of unexplained weight gain and back pain from a compression fracture of the vertebrae. On assessment, there is truncal obesity with excessively thin extremities, a moon-shaped face, a buffalo hump, thin hair, and adult acne. The symptoms described are suggestive of what disease?

Cushing disease

Which is the target tissue for the parathyroid gland?

Intestines

A client is diagnosed with hyperthyroidism, and surgery is scheduled because the client refuses ablation therapy. While awaiting the surgical date, what instruction should the nurse teach the client?

Eliminate coffee, tea, and cola from the diet.

Which statement is true regarding cortisol?

Cortisol stimulates gluconeogenesis.

In order to ensure a quality specimen and an accurate test result, which instruction should the nurse give a client who is scheduled to undergo urine endocrine testing?

"Store the urine specimen in a cooler with ice."

After surgical clipping of a ruptured cerebral aneurysm, a client develops the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). What manifestations are exhibited with excessive levels of antidiuretic hormone?

Hyponatremia and decreased urine output

A nurse is caring for a client with Addison disease. Which information should the nurse include in a teaching plan to encourage this client to modify dietary intake?

Extra salt is needed to replace the amount being lost caused by lack of sufficient aldosterone to conserve sodium.

What does the nurse state as the etiological factor of nephrogenic diabetes insipidus (DI)?

Lithium therapy

A nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective?

"I should control my blood glucose with diet, exercise, and medication."

A nurse is monitoring a client’s laboratory results for a fasting plasma glucose level. Within which range of a fasting plasma glucose level does the nurse conclude that a client is considered to be diabetic?

126

A nurse is caring for a client with a diagnosis of type 1 diabetes who has developed diabetic coma. Which element excessively accumulates in the blood to precipitate the signs and symptoms associated with this condition?

Ketones as a result of rapid fat breakdown, causing acidosis

Which statement regarding calcitonin is correct?

Its actions are opposite to that of parathyroid hormone.

A nurse working in the diabetes clinic is evaluating a client’s success with managing the medical regimen. What is the best indication that a client with type 1 diabetes is successfully managing the disease?

Stabilization of the serum glucose

A primary healthcare provider prescribes a low-sodium, high-potassium diet for a client with Cushing syndrome. Which explanation should the nurse provide to the client about the need to follow this diet?

"Excessive aldosterone and cortisone cause retention of sodium and loss of potassium."

Which hormonal deficiency reduces the growth of axillae and pubic hair in female clients?

Adrenocorticotropic hormone

Which hormone does the nurse state binds to the receptor site on the surface of a target cell?

Adrenaline

A client with malignant hot nodules of the thyroid gland has a thyroidectomy. What is the nurse’s priority action immediately postoperative?

Place in low-Fowler position to limit edema of the neck

Which hormone is released from the pancreas?

Somatostatin

A nurse observes that a client’s urine has a sweet fruity odor. Which information is most important to evaluate when performing a further client assessment?

Serum glucose level

A nurse explains to a client with diabetes that self-monitoring of blood glucose is preferred to urine glucose testing. Why is blood glucose monitoring preferred?

Blood glucose monitoring is more accurate.

Which hormonal deficiency causes diabetes insipidus in a client?

Antidiuretic hormone (ADH)

A client reports their lips feel thicker, as well as joint pain and coarse facial features. What should the nurse suspect as the cause of the anterior

Excessive secretion of growth hormone

What are the most common hormones produced in excess with hyperpituitarism? Select all that apply.

Prolactin, Growth Hormone

What will the nurse expect diagnostic studies of a client with Cushing syndrome to indicate?

High levels of 17-ketosteroids in a 24-hour urine test

What other name can the nurse use for vasopressin?

Antidiuretic hormone

What are the neurologic manifestations of hyperthyroidism?

Blurred vision Exophthalmos

A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include to decrease the risk of complications?

Examine the feet daily Wear well-fitting shoes Perform regular exercise

A nurse is caring for a client who has just returned from the postanesthesia care unit after having a thyroidectomy. Which action has priority during the first 24 hours after surgery when the nurse is concerned about thyroid storm?

Checking vital signs every two hours after they stabilize

The serum potassium level of a client who has diabetic ketoacidosis is 5.4 mEq/L (5.4 mmol/L). What would the nurse expect to see on the ECG tracing monitor?

Peaked T waves and widened QRS complexes

Which hormone does the nurse state has both inhibiting and releasing action?

Prolactin

Which medical condition could most probably result in clients developing primary diabetes insipidus (DI)?

Defect in hypothalamus

Which adverse effect can be seen in a female client with gonadotropin deficiency and undergoing hormone replacement therapy?

Thrombosis

A client who has had a subtotal thyroidectomy does not understand how hypothyroidism can develop when the problem was initially hyperthyroidism. On what fact should the nurse base her response?

There may not be enough thyroid tissue to supply adequate thyroid hormone.

A nurse is teaching a client with type 1 diabetes about assessing for signs and symptoms of hypoglycemia as a result of excessive insulin. What response should the nurse instruct the client to monitor in addition to nervousness and hunger?

Sweating

The nurse is caring for the client posttranssphenoidal hypophysectomy. When assessing the client, the nurse observes clear drainage from the nares. What could be the cause of this drainage?

A cerebral spinal fluid leak from an opening to the brain.

Which drug can cause diabetes insipidus?

Demeclocycline

A nurse is caring for a client newly diagnosed with type 1 diabetes. When the primary healthcare provider tries to regulate this client’s insulin regimen, the client experiences episodes of hypoglycemia and hyperglycemia, and 15 g of a simple sugar is prescribed. What is the reason this is administered when a client experiences hypoglycemia?

Increases blood glucose levels

A client is admitted for hypertension, and serum electrolyte studies have yielded abnormal results. The scheduled workup includes a scan for an aldosteronoma. What disease will this scan rule out?

Adrenal cortex

A client with type 2 diabetes, who is taking an oral hypoglycemic agent, is to have a serum glucose test early in the morning. The client asks the nurse, "What do I have to do to prepare for this test?" Which statement by the nurse reflects accurate information?

"Do not ingest anything before the test."

Which clinical manifestation occurs in a client with vasopressin deficiency?

Hypotension

A client who had a subtotal thyroidectomy asks how hypothyroidism may develop when the problem was hyperthyroidism. What should the nurse consider when formulating a response?

Less thyroid tissue is available to supply thyroid hormone after surgery.

Which hormonal deficiency causes breast atrophy in female clients?

Luteinizing hormone

Which condition is characterized by hemorrhage after a pregnant female delivers?

Sheehan’s syndrome

A client, visiting the health center, reports feeling nervous, irritable, and extremely tired. The client says to the nurse, "Although I eat a lot of food, I have frequent bouts of diarrhea and am losing weight." The nurse observes a fine hand tremor, an exaggerated reaction to external stimuli, and a wide-eyed expression. What laboratory tests may be prescribed to determine the cause of these signs and symptoms?

T3, T4, and thyroid-stimulating hormone (TSH)

Which hormone does the nurse state is formed from cholesterol?

Cortisol

The laboratory report of a client reveals increased serum cholesterol levels. Which other finding indicates growth hormone deficiency in the client?

Pathological fractures

The client’s pituitary gland must be removed. Which surgery will the client undergo?

Hypophysectomy

A nurse is reviewing several charts. Which condition is an autoimmune disorder?

Hashimoto’s disease

Four hours after surgery, the blood glucose level of a client who has type 1 diabetes is elevated. What intervention should the nurse implement?

Give supplemental doses of regular insulin

Which assessment finding in a client signifies a mild form of hypocalcemia?

Numbness around the mouth

Which hormone secretion does the nurse state is an example of a positive feedback mechanism?

Estradiol

Which hormonal deficiency would increase the client’s risk for fractures?

Growth Hormone

The registered nurse instructs the new nurse in orientation regarding the physiologic processes of the endocrine system prior to client assessment. Which statement made by the new nurse indicates effective learning?

"The hormones of the endocrine system exert their action by ‘lock and key’ mechanism."

A nurse teaches a client who has had a thyroidectomy for thyroid cancer to observe for signs of surgically induced hypothyroidism. What should be included in the teaching plan? Select all that apply.

Dry skin Lethargy Sensitivity to cold

A nurse is assessing a client with Cushing syndrome. Which signs should the nurse expect the client to exhibit? Select all that apply.

Hirsutism Round face Buffalo hump

What are the cardiovascular manifestations observed in a client with adrenal insufficiency?

Hyponatremia

What are the most common hormones produced in excess with hyperpituitarism? Select all that apply.

Prolactin Growth hormone

Which feature in the client indicates hypersecretion of adrenocorticotrophic hormone?

Moon Face

Which hormones does the nurse state are released by the hypothalamus? Select all that apply.

Melanocyte-inhibiting hormone (MIH) Corticotropin-releasing hormone (CRH) Growth hormone-releasing hormone (GHRH)

What assessment is the nurse’s main priority during the early postoperative period after a subtotal thyroidectomy?

Airway obstruction

Which procedure is preferred to find out the composition of a thyroid nodule and ascertain the need for further surgical intervention in a client?

Needle Biopsy

When obtaining a health history from a client recently diagnosed with type 1 diabetes, the nurse expects the client to report what clinical manifestations?

Polyuria, polydipsia, and polyphagia

How does the nurse arrange the events that take place during the promotion of glucose transportation into the cells through cell membranes?

Secretion of proinsulin by beta cells Storage of proinsulin in the pancreas Transformation of proinsulin into active insulin Attachment of insulin to receptors

A client has a history of hypothyroidism. Which skin condition should the nurse expect when performing a physical assessment?

Dry

What are the primary causes of adrenal insufficiency? Select all that apply.

Hemorrhage Tuberculosis Acquired immune deficiency syndrome

A client complains of fatigue, hair loss, and weight gain. On assessment, the client is found to have anemia. Which therapy does the nurse anticipate in the client’s prescription?

Levothyroxine

Which statement made by a diabetic client shows that dietary teaching by the nurse was effective?

"My diet can be planned around a wide variety of commonly used foods."

While assessing the health of a female client, the nurse suspects endocrine dysfunction. Which findings support the nurse’s suspicion? Select all that apply.

Diminished pubic hair Protrusion of eyeballs Blood pressure of 172/80 mm Hg

A client with Cushing syndrome asks why a low-sodium, high-potassium diet has been prescribed. What is the best response by the nurse?

"Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium."

The nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which finding in the client is consistent with the diagnosis?

retention of water

A client reports backache and abnormal increase in shoe size. The primary healthcare provider prescribes 100 g of oral glucose and blood and urine samples are collected for testing. Which finding in the client indicates an abnormality?

Growth hormone level is 7 ng/mL

A client with a family history of goiter is experiencing changes in voice and breathing. Which diagnostic study does the nurse consider to be beneficial in confirming a diagnosis?

Thyroid antibodies

While reviewing the laboratory reports of a client, the nurse finds that the client has low sodium levels. Which hormonal imbalance should the nurse suspect in the client?

Cortisol

A client is admitted to the hospital for a thyroidectomy. In which position should the nurse maintain the client after surgery?

Semi fowler

During the progressive stage of shock, anaerobic metabolism occurs. Which complication should the nurse anticipate in this client?

Metabolic acidosis

A primary healthcare provider prescribes propylthiouracil (PTU) for a client with hyperthyroidism. Two months after being started on the antithyroid medication, the client calls the nurse and complains of feeling tired and looking pale. What should the nurse do?

Schedule the client for an appointment.

A client’s parathyroid glands are removed. What clinical manifestation is indicative of the fluid and electrolyte imbalance associated with this surgery?

Muscle spasms

The nurse is caring for a client newly diagnosed with diabetes. What symptom of hypoglycemia is most common and should be taught to the client?

Confusion

A client is scheduled to have a thyroidectomy for thyroid cancer. What specific instruction about postoperative care should the nurse provide the client during preoperative teaching?

Support the head with the hands when changing position.

When obtaining the history of a client recently diagnosed with type 1 diabetes, what will the nurse expect to discover?

Weight loss

After assessing a client, the nurse anticipates that the client has hyperpituitarism. Which questions asked by the nurse helps confirm the diagnosis? Select all that apply.

"Is there any change in your vision?" "Do you experience severe headaches?" "Is there any change in your menstrual cycle?"

On reviewing the data of a client with thyroid disorder, the primary healthcare provider prescribed atenolol. Which assessment findings would indicate the need for atenolol therapy? Select all that apply.

Tachycardia Atrial fibrillation Systolic hypertension

The nurse is caring for a client with nephrogenic diabetes insipidus who is prescribed a low-sodium diet and chlorothiazide therapy. The client fails to respond to the therapy. Which alternative treatment should the nurse be prepared to administer?

Indomethacin

A nurse is assessing a client admitted to the hospital with a tentative diagnosis of a pituitary tumor. What signs of Cushing syndrome does the nurse identify?

Retention of sodium and water q

A female client is undergoing treatment for infertility. After therapy with clomiphene the client comes for follow-up visits and no results are seen. What further treatment does the nurse anticipate administering?

Human chorionic gonadotropin

The primary healthcare provider instructs the client to increase their intake of seafood and protein in the diet. What could be the reason for this instruction?

The client has hypothyroidism.

A client has a glycosylated hemoglobin measurement of 6%. What should the nurse conclude about this client when planning teaching strategies based on the results of this laboratory test?

The client has followed the treatment plan as prescribed.

The laboratory reports of a client who underwent a hypophysectomy show an intracranial pressure (ICP) of 20 mmHg. Which action made by the client is responsible for this condition?

Bending over at the waist

A female client who is scheduled for a thyroidectomy is concerned that the surgery will interfere with her ability to become pregnant. What is the nurse’s best response?

"As long as medication is continued, ovulation will occur."

The primary healthcare provider prescribes daily fasting blood glucose levels for a client with diabetes mellitus. What is the goal of treatment with glucose levels for this client?

70 to 105 mg/dL (3.9 to 5.8 mmol/L) of blood

The nurse is assisting the primary healthcare provider, who is examining the client’s skull radiograph. An abnormality in the endocrine gland situated in a depression of the sphenoid bone is suspected. Which hormone release is most probably affected?

Corticotropin

A nurse is caring for a client who is experiencing an underproduction of thyroxine (T4). Which client response is associated with an underproduction of thyroxine?

Myxedema

While assessing a postpartum client who is suspected of having a thyroid disorder, the nurse suspects that the client has autoimmune thyroiditis. Which diagnostic studies are most suitable for confirming the diagnosis?

Radioactive iodine uptake

What is the effect of parathyroid hormone on bones? Select all that apply.

Increased bone breakdown Increased serum calcium levels Increased net release of calcium and phosphorus

While caring for a client receiving hydrocortisone therapy, the nurse anticipates a dose adjustment in the client’s prescription. Which observation in the client supports this anticipation?

Sudden weight gain of 8 kg

A client with type 1 diabetes has an above-the-knee amputation because of severe lower extremity arterial disease. What is the nurse’s primary responsibility two days after surgery when preparing the client to eat dinner?

Checking the client’s serum glucose level

A nurse is caring for a client with Cushing syndrome. Which cardiovascular complication should the nurse assess for in this client?

Hyptension

A nurse is caring for a newly admitted client with a diagnosis of Graves disease. In preparing a teaching plan, the nurse anticipates which diet will be prescribed for this client?

High-calorie diet

A nurse provides post-operative care to a client who has undergone a hypophysectomy. Which action should the nurse take if there is a yellowish discharge at the dressing site?

Inform the primary healthcare provider

Postoperatively, a client who had a thyroidectomy complains of tingling and numbness of the fingers and toes, and the nurse observes muscle twitching. Which complication does the nurse suspect the client is experiencing?

Hypocalcemia

Upon assessing a female client, the nurse discovers an abnormal endocrine finding. Which finding in the client supports the nurse’s conclusion?

Protruding eyes

The primary healthcare provider prescribed carbamazepine to a client with central diabetes insipidus. The serum osmolarity is 600 mOsm (mmol)/kg. Which will be an effective outcome of the drug?

Decreased thirst

The primary health care provider prescribes fludrocortisone to a client with adrenal gland hypofunction. What does the nurse instruct the client about this medication?

"Regularly monitor blood pressure."

On the first postoperative day following a thyroidectomy, a client tolerates a full-fluid diet. This is changed to a soft diet on the second postoperative day. The client reports a sore throat when swallowing. What should the nurse do first?

Administer analgesics as prescribed before meals.

During thyroid surgery, a client’s parathyroid glands have become damaged. Which condition does the nurse expect the client to develop?

Tetany

A client with a parathyroid disorder reports nausea, vomiting, weight loss, and epigastric pain. Which electrolyte disturbance would be responsible for the client’s clinical manifestations?

Hypercalcemia

During a follow-up visit, the nurse finds increased intracranial pressure in a client who has undergone nasal hypophysectomy for hyperpituitarism. Which action taken by the client is responsible for this condition?

Blowing the nose and sneezing

A client feeling increasingly tired seeks medical care. Type 1 diabetes is diagnosed. What causes increased fatigue with type 1 diabetes?

Decreased production of insulin by the pancreas

Which drug acts as an abortifacient in female clients?

Mifepristone

Which electrolyte concentration has the potential to precipitate dysrhythmias and cardiac arrest in a client?

Serum potassium of 7.2 mEq/L (7.2 mmol/L)

A client complains of weight gain and purplish-blue striae on the abdomen. Which condition does the nurse anticipate in the client?

Cushing

The nurse is caring for a client immediately after a subtotal thyroidectomy. How will the nurse assess for unilateral injury of the laryngeal nerve?

Asking the client to say what the current time is

When assessing a client with Graves disease (hyperthyroidism), what would the nurse expect to find in the client’s history?

Diaphoresis

Which clinical manifestations in a client indicate hyperfunctional thyroid gland? Select all that apply.

Diarrhea weight loss

Which nursing intervention is the priority when a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?

Administering fluid replacement

Which clinical feature is indicative when a client has hypercortisolism?

Increased pigmentation

A client reports enlargement of the hands and feet, thickened lips, and joint pains. The client’s blood glucose is 250 mg/dL (13.89 mmol/L) and x-ray reports reveal increased size of the lungs. Which hormonal change does the nurse suspect in the client?

Growth hormone

The nurse is assessing the client admitted with diabetic ketoacidosis. Which statement made by the client indicates a need for further education on sick day management?

"I need to stop taking my insulin when I am ill because I am not eating."

A client is admitted to the hospital with a possible diagnosis of Addison disease. What is an important nursing responsibility during a 24-hour urine collection for this client?

Keeping the client quiet and reducing stress

A nurse is caring for a client with a history of hyperthyroidism who is now experiencing thyroid crisis (thyroid storm). What does the nurse consider to be the most likely precipitating factor in the client’s current health problem?

High levels of the hormone triiodothyronine

The nurse is assessing a client suspected of having hypersecretion of growth hormone. Which question should the nurse ask the client?

"Have you noticed thickening of your lips?"

A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiologic changes associated with a long history of diabetes?

Blurry, spotty, or hazy vision

A client who is scheduled to have surgery to remove an aldosterone-secreting adenoma asks the nurse what will happen if surgery is not performed. On what information should the nurse base a response?

The tumor must be removed to prevent heart and kidney damage.

A nurse is caring for a client with type 1 diabetes who developed ketoacidosis. Which laboratory value supports the presence of diabetic ketoacidosis?

Increased blood urea nitrogen levels OR Increased serum lipids

A client with severe diabetes insipidus is receiving desmopressin acetate, which is administered intranasally in a metered spray. During the follow-up visits, the client reports chest tightness to the primary healthcare provider. Which intervention would effectively reduce complications in the client? Select all that apply.

Administration of desmopressin acetate orally Administration of desmopressin acetate subcutaneously

A nurse is caring for a client who had an adrenalectomy. What clinical response should the nurse monitor while steroid therapy is being regulated?

Hypotension

A nurse is developing a discharge plan for a client hospitalized with severe cirrhosis of the liver. What should be included in this plan?

The importance of reporting personality changes to the primary healthcare provider

A registered nurse is teaching the student nurse the precautions to follow when blood samples are collected. Which statement made by the student nurse indicates effective learning?

"I can use a single-lumen line to obtain samples."

A nurse teaches a client with type 1 diabetes about the treatment of hypoglycemia. If the teaching is effective, which foods does the client identify to manage hypoglycemia?

Cheese sandwich and sugar

The nurse is caring for a client diagnosed with Cushing syndrome. What symptoms does the nurse expect the client to exhibit?

Lability of mood

A client is learning alternate site testing (AST) for glucose monitoring. Which client statement indicates to the nurse that additional teaching is necessary?

"The fingertip is preferred for glucose monitoring if hyperglycemia is suspected."

The nurse is teaching a diabetic client about the advantages of using an insulin pump. What information should the nurse include?

It can improve A1C levels. Clients can exercise without eating more carbohydrates.

The nurse is caring for a client in labor whose medical report states posterior pituitary hormone deficiency. Which medication administration is required for the client considering the medical condition?

Oxytocin to promote uterine contractions

A client with a small nodule of the thyroid gland is to have a subtotal thyroidectomy. The client asks the nurse for clarification about what this surgery involves. What information should the nurse include in a response to the question?

A small part of the gland is left intact.

A client with acromegaly and insulin-dependent diabetes undergoes a hypophysectomy. Which statement made by the client indicates a need for further teaching?

"I will require larger doses of insulin than I did preoperatively."

A nurse is caring for a client admitted to the hospital with primary hyperparathyroidism. Which action should be included in this client’s plan of care?

Ensuring a large fluid intake

The nurse concludes that a client with type 1 diabetes is experiencing hypoglycemia. Which responses support this conclusion? Select all that apply.

Headache Tachycardia Cool, Clammy skin

The nurse is teaching a client who underwent bilateral adrenalectomy about self-management after discharge. Which statements given by the client indicate effective learning? Select all that apply.

"I will procure an influenza vaccination yearly." "I will visit the hospital frequently for my lifelong hormonal therapy." "I will immediately notify my primary health care provider if I have fever."

A nurse is caring for a client admitted to the hospital with a diagnosis of Addison disease. The nurse should assess the client for what signs related to this disorder?

Hypoglycemia and hypotension

Which assessment finding is characteristic of a client with hypoparathyroidism?

Serum phosphorus of 5 mg/dL (1.61 mmol/L); serum magnesium of 0.9 mEq/L (0.9 mmol/L)

The nurse provides education related to manifestations of hyperglycemia to a client with type 1 diabetes. Which signs and symptoms identified by the client indicate that the teaching was effective? Select all that apply.

Thirst Fruity breath odor Excessive urination

A nurse is caring for a client with the clinical manifestation of hypotension associated with a diagnosis of Addison disease. Which hormone is impaired in its production as a result of this disease?

Mineralocorticoids

A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings related to this event should the nurse document in the client’s clinical record?

Acetone breath Decreased arterial carbon dioxide level

Which important intervention should the nurse include in the plan of care for a client with Addison disease?

Protecting the client from exertion

A client suspected of having a hyperactive thyroid is scheduled for protein-bound iodine, T3, and T4 laboratory tests. What should the nurse ask the client to ensure accuracy of the test?

Had recent x-rays using radiopaque dye

A client with addisonian crisis exhibits severe manifestations of glucocorticoid and mineralocorticoid deficiencies. Which responses should the nurse expect the client to exhibit?

Hyperkalemia Hyponatremia Postural hypotension

A client who has hypofunction of the adrenal gland is prescribed oral hydrocortisone. Which clinical finding indicates the need for dosage adjustment in the client? Select all that apply.

Fluid retention Rapid weight gain

A client with hyperthyroidism refuses radioactive iodine therapy, and a subtotal thyroidectomy is scheduled. The nurse reviews the preoperative plan of care and questions which prescription?

Drugs to increase the blood pressure

A nurse is caring for an older client who had non-insulin dependent diabetes for 15 years that progressed to insulin-dependent diabetes 2 years ago. What common complications of diabetes should the nurse assess for when examining this client? Select all that apply.

Leg ulcers Loss of visual acuity Prolonged capillary refill in the toes Decreased sensation in the lower extremities

A nurse is teaching a client with diabetes about the treatment of hypoglycemia. The nurse knows that teaching was effective if the client picks which foods to treat a hypoglycemic attack?

Sugar and a slice of bread.

A nurse is assessing a malnourished client with a history of cirrhosis. The client is experiencing nausea, ascites, and gastrointestinal bleeding. What is the primary cause of the client’s ascites?

A decrease in plasma protein to maintain adequate capillary-tissue circulation `

The laboratory reports of a client reveal selective hypopituitarism related to growth hormone (GH). What other findings does the nurse anticipate in the client? Select all that apply.

Decreased muscle strength Increased serum cholesterol

A client is diagnosed as having type 2 diabetes. What is a priority teaching goal for the client?

To identify pending hypoglycemia or hyperglycemia

A nurse is caring for an adult client with acromegaly. What clinical manifestation does the nurse expect the client to exhibit?

Prominent jaw

A female client has decreased bone density, dry skin, and dry perineal tissues, and the primary healthcare provider has identified a risk of cystitis. Which teaching should the nurse provide to the client? Select all that apply.

"Perform weight-bearing activity." "Drink at least 2 liters of fluids daily." "Use vaginal lubricants during sexual activity."

A nurse is caring for a client after a thyroidectomy. With concerns of nerve injury, what functional ability should the client be assessed for?

Speaking

A client has an abdominal perineal resection with the formation of a colostomy for cancer of the rectum. The nurse evaluates that teaching about colostomy care is understood when the client makes what statement?

"I will call the clinic and report if I have difficulty inserting the irrigating tube into the stoma."

The nurse is teaching a student nurse about caring for a client with decreased bone density. Which statements made by the student nurse indicates effective learning? Select all that apply.

"I will instruct the client to be very careful to prevent injuries." "I will instruct the client to perform weight-bearing activities."

What is a major nursing concern when caring for a client diagnosed with hyperthyroidism?

Arranging for sufficient rest periods

A client’s laboratory report reveals decreased serum and salivary cortisol levels and increased serum potassium level from hypofunctioning of the adrenal gland. The client is prescribed fludrocortisone. Which nursing action in the follow-up visit minimizes risk of a potential side effect of medication?

Monitoring the client’s blood pressure

The registered nurse is teaching the student nurse how to care for a client with hyperpituitarism who is being treated with bromocriptine mesylate. Which statement made by the student nurse indicates effective learning?

Low dose of the drug should be given while initiating therapy.

A nurse is reviewing a client’s history and finds images showing progressive development of facial changes due to acromegaly. Which diagnostic study would have confirmed this diagnosis?

Insulin-like growth factor 1 (IGF-1)

A client is scheduled for a computed tomography (CT) of the brain with contrast. When reviewing the client’s medical record, what significant finding should the nurse report to the primary healthcare provider before the diagnostic procedure?

The client takes metformin daily.

A nurse is caring for a client with a tentative diagnosis of pheochromocytoma who is receiving chlorpromazine. A 24-hour urine specimen to assess the presence of vanillylmandelic acid (VMA) is prescribed to assist in confirmation of the diagnosis. What information should the nurse include in the client teaching regarding this test? Select all that apply.

All urine excreted over the 24-hour period must be saved and refrigerated. Avoid coffee, chocolate, and citrus fruit for three days before and during the test.

A client is worried about what to expect after having a pancreatoduodenectomy (Whipple procedure) for cancer of the pancreas. What is most important for the nurse to know when helping this client plan for the future?

The stage and grade of the client’s cancer

A client who had a subtotal thyroidectomy returns to the unit from the postanesthesia care unit. What is the priority nursing action at this time?

Observe for signs of tetany.

What change in blood pressure (BP) should the nurse anticipate after a client has an aldosteronoma surgically removed?

Gradually return to expected levels for an adult

A client has undergone hypophysectomy. Which action would the nurse consider to be most appropriate during postoperative care to prevent a cerebrospinal fluid (CSF) leak?

Prohibiting coughing or sneezing

A client has a thyroidectomy for cancer of the thyroid. When evaluating for nerve injury, what should the client be asked to do?

Speak

A nurse is caring for a client with myxedema who has undergone abdominal surgery. What should the nurse consider when administering opioids to this client?

One-third to one-half the usual dose should be prescribed.

A client who is to begin continuous ambulatory peritoneal dialysis asks the nurse what this entails. What information should the nurse include when answering the client’s question?

Constant contact is maintained between the dialysate and the peritoneal membrane.

The nurse is teaching a client who underwent a hypophysectomy for hyperpituitarism about self-management. Which actions performed by the client could cause complications on the second post-operative day? Select all that apply.

Nose blowing Teeth brushing Bending forward

What interventions should the nurse implement in caring for a client with diabetes insipidus (DI) following a head injury?

Providing adequate fluids within easy reach Assessing for and reporting changes in neurological status Monitoring for constipation, weight loss, hypotension, and tachycardia

A nurse is assessing a client with diabetes insipidus. Which signs indicative of diabetes insipidus should the nurse identify when assessing the client?

Excessive thirst Dry mucous membranes Decreased urine specific gravity

A client’s laboratory values demonstrate an increased serum calcium level, and further diagnostic tests reveal hyperparathyroidism. What clinical manifestations might the nurse identify when assessing this client?

Cardiac dysrhythmias Hypoactive bowel sounds

A client is admitted with a diagnosis of Cushing syndrome. Which clinical manifestations should the nurse expect the client to exhibit?

Weakness Hypertension Truncal obesity

A nurse is assessing a client with a diagnosis of hypoglycemia. What clinical manifestations support this diagnosis?

Palpitations Diaphoresis Slurred speech

The client is admitted to the hospital with a large goiter, and a thyroidectomy is performed. What should the nurse do during the first four hours after the surgery?

Monitor for stridor or dyspnea Assess the sides and back of the client’s neck for evidence of bleeding

Two clients with polydipsia and polyuria arrived at the hospital. Both were having similar symptoms but were diagnosed with different types of diabetes insipidus. Which assessment finding helped to differentiate the diagnosis?

Urine osmolarity

A nurse is monitoring for clinical manifestations of infection in a client with a diagnosis of Addison disease. Which body mechanism related to infectious processes does the nurse conclude is impaired as a result of this disease?

Stress response

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